DCD, Plagiocephaly, Torticollis, BPI, DDH, Club Foot, Osteogenesis Imperfecta
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| Developmental Coordination Disorder (DCD) | 'clumsy child' & developmental apraxia. motor coordination - not due to a general medical condition
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| Developmental Coordination Disorder (DCD) clinical presentation | poor gross & fine motor skills (unable to skip, diff w/crossing midline, poor handwriting, unable to tie shoes) muscle weakness & low tone, requires verbal & visual cues
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| DCD task performance | re-learning a task each time attempted
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| Plagiocephaly | 'a flattened head' incidence (back to sleep campaign), positional; plagio, brachy, scapho. Crainiosynostosis - sutures fused together wrong
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| Plagiocephaly PT intervention | prone positioning!! helmet in severe cases. see by 2 months, 10-12 months too late
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| Torticollis presentation | asymmetrical posturing of head & neck, sidebend to ipsilateral side w/rotation to contralateral side (named for direction of tilt - 75% right)
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| Torticollis types | sternomastoid tumor, muscular, post-postural
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| Torticollis clinical presentation | Right - shortening of R upper trap & L splenius capitus. Significan trunk tightness, decreased symmetrical upper & lower body rotation & lateral flexion
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| Torticollis secondary complications | developmental delay, shoulder elevation, decreased midline control & ROM during growth spurts, fussiness, irritability w/poor self-calming, decreased tolerance to movement, pain.
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| Torticollis PT intervention | cargiver education!! positioning, stretching, developmental motor skills, facilitation of 'opposing' musculature
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| Brachial Plexus Injury (BPI) | Incidence 1/1000 births, Paralysis or weakness of the UE due to trauma to C5-T1 spinal nerve roots
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| Types of Brachial Plexus Injury (BPI) | Erb's Palsy (C5-C6 - waiter's tip), Klumpke's Palsy (C8-T1 - claw hand, don't have elbow ext, int rot & finger ext), Erb/Klumpke - entire UE involved
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| Causes of Brachial Plexus Injury (BPI) | difficult labor, large baby, hypotonic infant, (traction on should during delivery in breech position or head & neck during vertex delivery
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| Symptoms of OPBI | facial involvement, clavicular/humeral fx, subluxation of shld, torticollis, partial paralysis to diaphram (C4)
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| BPI PT intervention | E-stim, Botox, position/active movement promotion, modified constraint-induced protocols
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| BPI surgical intervention | neurosurgery between 6-12m, before 12m ideal, effectiveness is ?. Ortho surgery for contractures/postural problems
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| Developmental Dysplasia of the Hip (DDH)/Congential Hips Dysplasia (CHD) - Treatment | up to 6m - positioning in hip flex & abd. up to 12m - closed reduction, spica cast. over 1yr - surgical osteotomy (pavlik harness/casting)
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| Club Foot | plantarflexion, inversion - varus (rearfoot), midfoot/forefoot add & supination. 1/1,000 births, 2:1 males. bilateral approx 30-50% of cases
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| Clubfoot Classification Category 1 | postural cluvfoot, flexible deformity, medial & plantar deviation of had/neck of talus, foot size equal no atrophy
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| Clubfoot Classification Category 2 | true club feet, fixed deformity, involves talonavicular & midtarsal jts, navicular & entrie forefoot add & supinated, soft tissues of calf & foot are contracted & underdeveloped
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| Clubfoot Classification Category 3 | sever, fixed deformity, usually associated w/myelodysplasia, may have other severe neuromusculoskeletal problems
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| Clubfoot Interventions | correct deformity early (prior to 1yr) and completely. Maintain corrected position until foot stops growing (ponseti serial casting & Dennis Brown Splint). Mild cases mixed in surgical outcome
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| Osteogenesis Imperfecta | Brittle bone disease. Inherited disorder of connective tissue resulting in gfragile bones & recurrent fractures, muscle weakness & ligmentous laxity w/blue sclera
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| Osteogenesis Imperfecta Incidence & severity | 1/200,000 birth. Mild - forms classified differently. Severe - multiple fractures at birth 7 infants do not usually survive.
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| Osteogenesis Imperfecta Management | Bisphosphonate, bone marrow transplant or surgical -intermedullary rods in long bones.
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| Osteogenesis Imperfecta PT Management | Family education & SUPPORT/COUNSELING. ROM & strengthening program-usually aquatic, reduce injury, splinting, casting, assistive devices (prevent deformities)
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| Legg Calve Perthes Disease | Boys 4:1, 4-12yrs. Disease of the hip initiated by avascular necrosis of femoral head
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| Legg Calve Perthes Disease Presentation | limp w/pain referred to groin, thigh & knee. Hip ROM limitation in IR, abd & flex
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| Legg Calve Perthes Disease Medical Intervention | orthotic use to maintain hip approximation, surgery.
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| Legg Calve Perthes Disease PT Intervention | strengthening & ROM pre/post orthotic or surgical management. Maintain pain-free ROM & non-weight bearing during progressive stage
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| Slipped Capital Femoral Epiphysis | Boys, 11-15, obesity factor. Femoral head slips or is displaced from normal alignment w/femoral neck.
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| Slipped Capital Femoral Epiphysis Clinical Presentation | pain-groin, medial thigh or knee, limp, ER of LE, limited hip flex, abd & IR
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| Slipped Capital Femoral Epiphysis Medical Intervention | stabilize growth plate through bedrest, traction or surgical pinning
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| Slipped Capital Femoral Epiphysis PT Intervention | NWB, gain training
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| Autism | behavior conditions existing on continuum involving: socialization, communication, repetitive behavior
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| Autism Clinical signs | evident before 3 yrs old. poor eye contact, koesn't know how to play w/toys, excessively lines up toys or objects, overly attached to one particular toy/object, doesn't smile, appear hearing impaired
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| Autism PT Presentation | 60-80% demonstrate motor signs, poor muscle tone (hypotonia), poor motor planning, toe walking, sensory impairments (hypo/hyper)
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| Autism PT Intervention | sensory integration, coordination activities, motor patterning /planning, low tone, focus on safety, benefit from increased structure or consistent plan, decreased verbal interaction (communication w/pictures/visual aids)
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